TY - JOUR A1 - Esser, Günter A1 - Blank, Sarah T1 - Efficacy of psychotherapy with children and adolescents JF - Praxis der Kinderpsychologie und Kinderpsychiatrie : Ergebnisse aus Psychotherapie, Beratung und Psychiatrie N2 - Efficacy of Psychotherapy with Children and Adolescents Psychotherapeutic interventions require empirical as well as scientific assessment. Specifically, the proven efficacy of psychotherapy for children and adolescents is essential. Thus, studies examining treatment efficacy and meta-analyses are necessary to compare effect sizes of individual therapeutic interventions between treatment groups and waiting control groups. Assessment of 138 primary studies from 1993-2009 documented the efficacy of psychotherapy for children and adolescents. Furthermore, behavioural therapy outperformed non-behavioural interventions, as 90 % of behavioural interventions showed larger effect sizes compared to non-behavioural psychotherapy. Analysis of moderator variables demonstrated an improved treatment efficacy for individual therapy, inclusion of the family, treatment of internalised disorders, and in clinical samples. Stability of psychotherapeutic treatment effects over time was demonstrated. KW - psychotherapy KW - efficacy KW - child and adolescent psychotherapy KW - meta-analysis Y1 - 2011 SN - 0032-7034 VL - 60 IS - 8 SP - 626 EP - 638 PB - Vandenhoeck & Ruprecht CY - Göttingen ER - TY - JOUR A1 - Kühne, Franziska A1 - Maas, Jana A1 - Wiesenthal, Sophia A1 - Weck, Florian T1 - Supervision in der Verhaltenstherapie T1 - Supervision in behavioral therapy BT - ein Scoping Review zur Identifikation von Forschungszielen BT - a scoping review for identification of research objectives JF - Zeitschrift für klinische Psychologie und Psychotherapie : Forschung und Praxis N2 - Theoretischer Hintergrund:Supervision spielt eine zentrale Rolle zum Wissens- und Kompetenzerwerb sowie in der Qualitätssicherung. Fragestellung:Ziel war es, den aktuellen Forschungsstand zur Supervision im Rahmen der kognitiven Verhaltenstherapie abzubilden, um daraus Schlussfolgerungen für die zukünftige Forschung abzuleiten. Methode:Zur Evidenzsynthese wurde ein Scoping Review durchgeführt, das die Darstellung zentraler Konzepte, aktueller Evidenz und möglicher Forschungsbedarfe ermöglichte. Neben einer systematischen Literaturrecherche wurden Vorwärts- und Rückwärtssuchstrategien eingesetzt. Ergebnisse:Eingeschlossen wurden zwölf Publikationen basierend auf zehn empirischen Studien. Alle Studien beschrieben Ausbildungssettings, aber nur wenige untersuchten übende Interventionen (z. B. Rollenspiele). Häufig wurden Effekte subjektiv erfasst, die methodische Qualität der Begleitstudien variierte. Schlussfolgerungen:Notwendig sind weitere methodisch hochwertige Studien, experimentell orientiert oder in der klinischen Praxis, die die Supervisionsforschung bereichern können. N2 - Background:Supervision plays a central role for the acquisition of therapeutic knowledge and competence and for quality control. Objective:The study aimed at mapping the current evidence regarding cognitive–behavioral supervision, and drawing conclusions for future research. Method:For evidence synthesis, we conducted a scoping review to outline key concepts, the current evidence, and potential gaps in research. In addition to a systematic literature search, forward and backward search strategies were implemented. Results:We included 12 publications on 10 empirical studies. All studies referred to education and training, but only a few examined exercises (e. g., role plays). Mostly, outcomes were evaluated subjectively, and study quality varied. Conclusion:Further methodologically sound studies, experimentally oriented or in clinical care, may support research. KW - clinical supervision KW - review KW - scoping study KW - cognitive behavioral therapy KW - psychotherapy KW - klinische Supervision KW - Übersichtsarbeit KW - kognitive Verhaltenstheraphie KW - Psychoterapie Y1 - 2017 U6 - https://doi.org/10.1026/1616-3443/a000414 SN - 1616-3443 SN - 2190-6297 VL - 46 IS - 2 SP - 73 EP - 82 PB - Hogrefe CY - Göttingen ER - TY - JOUR A1 - Heinzel, Stephan A1 - Rapp, Michael Armin A1 - Fydrich, Thomas A1 - Ströhle, Andreas A1 - Teran, Christina A1 - Kallies, Gunnar A1 - Schwefel, Melanie A1 - Heissel, Andreas T1 - Neurobiological mechanisms of exercise and psychotherapy in depression BT - the SPeED studyRationale, design, and methodological issues JF - Clinical Trials N2 - Background/Aims: Even though cognitive behavioral therapy has become a relatively effective treatment for major depressive disorder and cognitive behavioral therapy-related changes of dysfunctional neural activations were shown in recent studies, remission rates still remain at an insufficient level. Therefore, the implementation of effective augmentation strategies is needed. In recent meta-analyses, exercise therapy (especially endurance exercise) was reported to be an effective intervention in major depressive disorder. Despite these findings, underlying mechanisms of the antidepressant effect of exercise especially in combination with cognitive behavioral therapy have rarely been studied to date and an investigation of its neural underpinnings is lacking. A better understanding of the psychological and neural mechanisms of exercise and cognitive behavioral therapy would be important for developing optimal treatment strategies in depression. The SPeED study (Sport/Exercise Therapy and Psychotherapyevaluating treatment Effects in Depressive patients) is a randomized controlled trial to investigate underlying physiological, neurobiological, and psychological mechanisms of the augmentation of cognitive behavioral therapy with endurance exercise. It is investigated if a preceding endurance exercise program will enhance the effect of a subsequent cognitive behavioral therapy. Methods: This study will include 105 patients diagnosed with a mild or moderate depressive episode according to the Diagnostic and Statistical Manual of Mental Disorders (4th ed.). The participants are randomized into one of three groups: a high-intensive or a low-intensive endurance exercise group or a waiting list control group. After the exercise program/waiting period, all patients receive an outpatient cognitive behavioral therapy treatment according to a standardized therapy manual. At four measurement points, major depressive disorder symptoms (Beck Depression Inventory, Hamilton Rating Scale for Depression), (neuro)biological measures (neural activations during working memory, monetary incentive delay task, and emotion regulation, as well as cortisol levels and brain-derived neurotrophic factor), neuropsychological test performance, and questionnaires (psychological needs, self-efficacy, and quality of life) are assessed. Results: In this article, we report the design of the SPeED study and refer to important methodological issues such as including both high- and low-intensity endurance exercise groups to allow the investigation of dose-response effects and physiological components of the therapy effects. Conclusion: The main aims of this research project are to study effects of endurance exercise and cognitive behavioral therapy on depressive symptoms and to investigate underlying physiological and neurobiological mechanisms of these effects. Results may provide important implications for the development of effective treatment strategies in major depressive disorder, specifically concerning the augmentation of cognitive behavioral therapy by endurance exercise. KW - Major depressive disorder KW - depression KW - psychotherapy KW - cognitive behavioral therapy KW - endurance exercise KW - training KW - functional magnetic resonance imaging KW - brain-derived neurotrophic factor KW - basic psychological needs KW - cortisol Y1 - 2017 U6 - https://doi.org/10.1177/1740774517729161 SN - 1740-7745 SN - 1740-7753 VL - 15 IS - 1 SP - 53 EP - 64 PB - Sage Publ. CY - London ER - TY - GEN A1 - Kühne, Franziska A1 - Lesser, Hannah A1 - Petri, Franziska A1 - Weck, Florian T1 - Do mental health patients learn what their cognitive-behaviour therapists think they do? BT - a short report on qualitative interviews comparing perspectives T2 - Postprints der Universität Potsdam : Humanwissenschaftliche Reihe N2 - Purpose: The acquisition of skills is essential to the conceptualization of cognitive-behavioural therapy. Yet, what experiences are encountered and what skills actually learned during therapy, and whether patients and therapists have concurrent views hereof, remains poorly understood. Method: An explorative pilot study with semi-structured, corresponding interview guides was conducted. Pilot data from our outpatient unit were transcribed and content-analyzed following current guidelines. Results: The responses of 18 participants (patients and their psychotherapists) were assigned to six main categories. Educational and cognitive aspects were mentioned most frequently and consistently by both groups. Having learned Behavioural alternatives attained the second highest agreement between perspectives. Conclusions: Patients and therapists valued CBT as an opportunity to learn new skills, which is an important prerequisite also for the maintenance of therapeutic change. We discuss limitations to generalizability but also theoretical and therapy implications. T3 - Zweitveröffentlichungen der Universität Potsdam : Humanwissenschaftliche Reihe - 490 KW - cognitive-behavioural therapy (CBT) KW - psychotherapy KW - interview study KW - learning KW - skills Y1 - 2018 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:kobv:517-opus4-420607 SN - 1866-8364 IS - 490 ER - TY - JOUR A1 - Kühne, Franziska A1 - Lesser, Hannah A1 - Petri, Franziska A1 - Weck, Florian T1 - Do mental health patients learn what their cognitive-behaviour therapists think they do? BT - A short report on qualitative interviews comparing perspectives JF - International Journal of Qualitative Studies on Health and Well-being N2 - Purpose: The acquisition of skills is essential to the conceptualization of cognitive-behavioural therapy. Yet, what experiences are encountered and what skills actually learned during therapy, and whether patients and therapists have concurrent views hereof, remains poorly understood. Method: An explorative pilot study with semi-structured, corresponding interview guides was conducted. Pilot data from our outpatient unit were transcribed and content-analyzed following current guidelines. Results: The responses of 18 participants (patients and their psychotherapists) were assigned to six main categories. Educational and cognitive aspects were mentioned most frequently and consistently by both groups. Having learned Behavioural alternatives attained the second highest agreement between perspectives. Conclusions: Patients and therapists valued CBT as an opportunity to learn new skills, which is an important prerequisite also for the maintenance of therapeutic change. We discuss limitations to generalizability but also theoretical and therapy implications. KW - cognitive-behavioural therapy (CBT) KW - psychotherapy KW - interview study KW - learning KW - skills Y1 - 2018 U6 - https://doi.org/10.1080/17482631.2018.1527598 SN - 1748-2631 SN - 1748-2623 VL - 13 IS - 1 PB - Taylor & Francis Group CY - London ER - TY - JOUR A1 - Philipp, Rebecca A1 - Kriston, Levente A1 - Lanio, Jana A1 - Kühne, Franziska A1 - Härter, Martin A1 - Moritz, Steffen A1 - Meister, Ramona T1 - Effectiveness of metacognitive interventions for mental disorders in adults-A systematic review and meta-analysis (METACOG) JF - Clinical psychology & psychotherapy N2 - We evaluated the effectiveness and acceptability of metacognitive interventions for mental disorders. We searched electronic databases and included randomized and nonrandomized controlled trials comparing metacognitive interventions with other treatments in adults with mental disorders. Primary effectiveness and acceptability outcomes were symptom severity and dropout, respectively. We performed random-effects meta-analyses. We identified Metacognitive Training (MCTrain), Metacognitive Therapy (MCTherap), and Metacognition Reflection and Insight Therapy (MERIT). We included 49 trials with 2,609 patients. In patients with schizophrenia, MCTrain was more effective than a psychological treatment (cognitive remediation, SMD = -0.39). It bordered significance when compared with standard or other psychological treatments. In a post hoc analysis, across all studies, the pooled effect was significant (SMD = -0.31). MCTrain was more effective than standard treatment in patients with obsessive-compulsive disorder (SMD = -0.40). MCTherap was more effective than a waitlist in patients with depression (SMD = -2.80), posttraumatic stress disorder (SMD = -2.36), and psychological treatments (cognitive-behavioural) in patients with anxiety (SMD = -0.46). In patients with depression, MCTherap was not superior to psychological treatment (cognitive-behavioural). For MERIT, the database was too small to allow solid conclusions. Acceptability of metacognitive interventions among patients was high on average. Methodological quality was mostly unclear or moderate. Metacognitive interventions are likely to be effective in alleviating symptom severity in mental disorders. Although their add-on value against existing psychological interventions awaits to be established, potential advantages are their low threshold and economy. KW - mental disorders KW - meta-analysis KW - metacognition KW - psychotherapy KW - systematic review Y1 - 2018 U6 - https://doi.org/10.1002/cpp.2345 SN - 1063-3995 SN - 1099-0879 VL - 26 IS - 2 SP - 227 EP - 240 PB - Wiley CY - Hoboken ER - TY - JOUR A1 - Domhardt, Matthias A1 - Gesslein, Helene A1 - von Rezori, Roman Enzio A1 - Baumeister, Harald T1 - Internet- and mobile-based interventions for anxiety disorders BT - a meta-analytic review of intervention components JF - Depreddion and anxiety N2 - BackgroundAlthough the efficacy of Internet- and mobile-based interventions (IMIs) for anxiety is established, little is known about the intervention components responsible for therapeutic change. We conducted the first comprehensive meta-analytic review of intervention components of IMIs for adult anxiety disorders. MethodsRandomized controlled trials (RCTs) comparing IMIs for anxiety disorders to active online control groups, or IMIs to dismantled variations of the same intervention ( specific components) were identified by a systematic literature search in six databases. Outcomes were validated observer-rated or self-report measures for anxiety symptom severity and treatment adherence (number of completed modules and completer rate). This meta-analytic review is registered with PROSPERO (CRD42017068268). ResultsWe extracted the data of 34 RCTs (with 3,724 participants) and rated the risk of bias independently by two reviewers. Random-effects meta-analyses were performed on 19 comparisons of intervention components (i.a., different psychotherapeutic orientations, disorder-specific vs. transdiagnostic approaches, guidance factors). IMIs had a large effect when compared to active online controls on symptom severity (standardized mean difference [SMD] of -1.67 [95% CI: -2.93, -0.42]; P=0.009). Thereby, guided IMIs were superior to unguided interventions on symptom severity (SMD of -0.39 [95% CI: -0.59, -0.18]; P=0.0002) and adherence (SMD of 0.38 [95% CI: 0.10, 0.66]; P=0.007). ConclusionsOverall, the results of this meta-analysis lend further support to the efficacy of IMIs for anxiety, pointing to their potential to augment service supplies. Still, future research is needed to determine which ingredients are essential, as this meta-analytic review found no evidence for incremental effects of several single intervention components apart from guidance. KW - active ingredient KW - change mechanism KW - common and specific factor KW - e-health KW - guidance KW - psychotherapy Y1 - 2019 U6 - https://doi.org/10.1002/da.22860 SN - 1091-4269 SN - 1520-6394 VL - 36 IS - 3 SP - 213 EP - 224 PB - Wiley CY - Hoboken ER - TY - JOUR A1 - Kühne, Franziska A1 - Lacki, Fiona Janina A1 - Muse, Kate A1 - Weck, Florian T1 - Strengthening competence of therapists-in-training in the treatment of health anxiety (hypochondriasis) BT - validation of the assessment of Core CBT Skills (ACCS) JF - Clinical psychology & psychotherapy : an international journal of theory and practice N2 - Although the observation and assessment of psychotherapeutic competences are central to training, supervision, patient care, quality control, and life-long practice, structured instruments are used only occasionally. In the current study, an observation-based tool for the Assessment of Core CBT Skills (ACCS) was translated into German and adapted, and its psychometric properties were pilot evaluated. Competence of therapists-in-training was assessed in a random sample of n = 30 videos on cognitive behavioural therapy including patients diagnosed with hypochondriasis. Two of three raters independently assessed the competences demonstrated in the entire, active treatment sessions (n = 60). In our sample, internal consistency was excellent, and interrater reliability was good. Convergent validity (Cognitive Therapy Scale) and discriminant validity (Helping Alliance Questionnaire) were within the expected ranges. The ACCS total score did not significantly predict the reduction of symptoms of hypochondriasis, and a one-factorial structure of the instrument was found. By providing multiple opportunities for feedback, self-reflection, and supervision, the ACCS may complement current tools for the assessment of psychotherapeutic competences and importantly support competence-based training and supervision. KW - adherence KW - assessment KW - process research KW - psychotherapy KW - skill Y1 - 2019 U6 - https://doi.org/10.1002/cpp.2353 SN - 1063-3995 SN - 1099-0879 VL - 26 IS - 3 SP - 319 EP - 327 PB - Wiley CY - Hoboken ER - TY - JOUR A1 - Kühne, Franziska A1 - Meister, Ramona A1 - Maass, Ulrike A1 - Paunov, Tatjana A1 - Weck, Florian T1 - How reliable are therapeutic competence ratings? BT - results of a systematic review and meta-analysis JF - Cognitive therapy and research N2 - Assessments of psychotherapeutic competencies play a crucial role in research and training. However, research on the reliability and validity of such assessments is sparse. This study aimed to provide an overview of the current evidence and to provide an average interrater reliability (IRR) of psychotherapeutic competence ratings. A systematic review was conducted, and 20 studies reported in 32 publications were collected. These 20 studies were included in a narrative synthesis, and 20 coefficients were entered into the meta-analysis. Most primary studies referred to cognitive-behavioral therapies and the treatment of depression, used the Cognitive Therapy Scale, based ratings on videos, and trained the raters. Our meta-analysis revealed a pooled ICC of 0.82, but at the same time severe heterogeneity. The evidence map highlighted a variety of variables related to competence assessments. Further aspects influencing the reliability of competence ratings and regarding the considerable heterogeneity are discussed in detail throughout the manuscript. KW - competency KW - therapist competence KW - adherence KW - psychotherapy KW - assessment Y1 - 2019 U6 - https://doi.org/10.1007/s10608-019-10056-5 SN - 0147-5916 SN - 1573-2819 VL - 44 IS - 2 SP - 241 EP - 257 PB - Springer CY - New York ER - TY - THES A1 - Perlich, Anja T1 - Digital collaborative documentation in mental healthcare T1 - Digitale Mittel zur kooperativen Dokumentation im Bereich der psychischen Gesundheit N2 - With the growth of information technology, patient attitudes are shifting – away from passively receiving care towards actively taking responsibility for their well- being. Handling doctor-patient relationships collaboratively and providing patients access to their health information are crucial steps in empowering patients. In mental healthcare, the implicit consensus amongst practitioners has been that sharing medical records with patients may have an unpredictable, harmful impact on clinical practice. In order to involve patients more actively in mental healthcare processes, Tele-Board MED (TBM) allows for digital collaborative documentation in therapist-patient sessions. The TBM software system offers a whiteboard-inspired graphical user interface that allows therapist and patient to jointly take notes during the treatment session. Furthermore, it provides features to automatically reuse the digital treatment session notes for the creation of treatment session summaries and clinical case reports. This thesis presents the development of the TBM system and evaluates its effects on 1) the fulfillment of the therapist’s duties of clinical case documentation, 2) patient engagement in care processes, and 3) the therapist-patient relationship. Following the design research methodology, TBM was developed and tested in multiple evaluation studies in the domains of cognitive behavioral psychotherapy and addiction care. The results show that therapists are likely to use TBM with patients if they have a technology-friendly attitude and when its use suits the treatment context. Support in carrying out documentation duties as well as fulfilling legal requirements contributes to therapist acceptance. Furthermore, therapists value TBM as a tool to provide a discussion framework and quick access to worksheets during treatment sessions. Therapists express skepticism, however, regarding technology use in patient sessions and towards complete record transparency in general. Patients expect TBM to improve the communication with their therapist and to offer a better recall of discussed topics when taking a copy of their notes home after the session. Patients are doubtful regarding a possible distraction of the therapist and usage in situations when relationship-building is crucial. When applied in a clinical environment, collaborative note-taking with TBM encourages patient engagement and a team feeling between therapist and patient. Furthermore, it increases the patient’s acceptance of their diagnosis, which in turn is an important predictor for therapy success. In summary, TBM has a high potential to deliver more than documentation support and record transparency for patients, but also to contribute to a collaborative doctor-patient relationship. This thesis provides design implications for the development of digital collaborative documentation systems in (mental) healthcare as well as recommendations for a successful implementation in clinical practice. N2 - Die Verbreitung von Informationstechnologie kann die Rolle von Patienten verändern: weg vom passiven Erhalt ärztlicher Zuwendung hin zur eigenverantwortlichen Mitwirkung an ihrer Genesung. Wesentliche Schritte zur Ermündigung von Patienten sind eine gute Zusammenarbeit mit dem behandelnden Arzt und der Zugang zu den eigenen Akten. Unter Psychotherapeuten gibt es jedoch einen impliziten Konsens darüber, dass die Einsicht in psychiatrische Akten unvorhersehbare, nachteilige Effekte auf die klinische Praxis hervorrufen könnte. Um auch Patienten aktiver an der Erhaltung und Wiederherstellung ihrer mentalen Gesundheit zu beteiligen, ermöglicht Tele-Board MED (TBM) das gemeinschaftliche Erstellen von digitalen Notizen. Diese Dissertation beschreibt die Entwicklung des TBM Software-Systems, das es Therapeut und Patient ermöglicht, gemeinsam während der Sitzung wie auf einem Whiteboard Notizen zu machen. Außerdem bietet TBM Funktionen, um auf Grundlage der digitalen Gesprächsnotizen automatisch Sitzungsprotokolle und klinische Fallberichte zu erstellen. Methodologisch basiert die Entwicklung und Evaluierung von TBM auf dem Paradigma für Design Research. Es wurden vielfältige Studien in den Bereichen der Verhaltens- und Suchttherapie durchgeführt, um die Auswirkungen auf folgende Aspekte zu evaluieren: 1) die Erfüllung der Dokumentationspflichten von Therapeuten, 2) das Engagement von Patienten in Behandlungsprozessen und 3) die Beziehung zwischen Patient und Therapeut. Die Studien haben gezeigt, dass Therapeuten dazu geneigt sind, TBM mit ihren Patienten zu nutzen, wenn sie technologie-freundlich eingestellt sind und wenn es zum Behandlungskontext passt. Zur Akzeptanz tragen auch die schnelle Erstellung von klinischen Dokumenten sowie die Erfüllung der gesetzlichen Forderung nach Aktentransparenz bei. Weiterhin schätzen Therapeuten TBM als Werkzeug, um Therapiegespräche zu strukturieren und während der Sitzung schnell auf Arbeitsblätter zuzugreifen. Therapeuten äußerten hingegen auch Skepsis gegenüber der Technologienutzung im Patientengespräch und vollständiger Aktentransparenz. Patienten erhoffen sich von TBM eine verbesserte Kommunikation mit ihrem Therapeuten und denken, dass sie sich besser an die Gesprächsinhalte erinnern können, wenn sie eine Kopie ihrer Akte erhalten. Patienten brachten Bedenken zum Ausdruck, TBM in Situationen zu nutzen, in denen der Beziehungsaufbau im Vordergrund steht, und darüber, dass Therapeuten sich abgelenkt fühlen könnten. Als TBM im klinischen Umfeld eingesetzt wurde, wurde ein erhöhtes Patientenengagement und ein gesteigertes Teamgefühl beobachtet. Außerdem stieg bei Patienten die Akzeptanz ihrer Diagnosen, welche wiederum ein wichtiger Prädiktor für Therapieerfolg ist. Zusammenfassend lässt sich festhalten, dass TBM großes Potential hat: Über die damit mögliche Dokumentationsunterstützung und Aktentransparenz hinaus wird auch die Zusammenarbeit von Therapeut und Patient unterstützt. Diese Dissertation fasst Kriterien zur Entwicklung von gemeinschaftlichen Dokumentationssystemen in der (psychischen) Gesundheitsfürsorge sowie Empfehlungen für eine erfolgreiche Implementierung in der klinischen Praxis zusammen. KW - medical documentation KW - psychotherapy KW - addiction care KW - computer-mediated therapy KW - digital whiteboard KW - patient empowerment KW - doctor-patient relationship KW - design research KW - user experience KW - evaluation KW - medizinische Dokumentation KW - Psychotherapie KW - Suchtberatung und -therapie KW - computervermittelte Therapie KW - digitales Whiteboard KW - Patientenermündigung KW - Arzt-Patient-Beziehung KW - Design-Forschung KW - User Experience KW - Evaluation Y1 - 2019 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:kobv:517-opus4-440292 ER -